Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis
Abstract Background Both instrumented and stand-alone lateral lumbar interbody fusion (LLIF) have been widely used to treat lumbar degenerative disease. However, it remains controversial as whether posterior internal fixation is required when LLIF is performed. This meta-analysis aims to compare the...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07214-6 |
| _version_ | 1797276211040223232 |
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| author | Lianghai Jiang Lantao Liu Liang Dong Zhengwei Xu Xiaobo Zhang Lixiong Qian |
| author_facet | Lianghai Jiang Lantao Liu Liang Dong Zhengwei Xu Xiaobo Zhang Lixiong Qian |
| author_sort | Lianghai Jiang |
| collection | DOAJ |
| description | Abstract Background Both instrumented and stand-alone lateral lumbar interbody fusion (LLIF) have been widely used to treat lumbar degenerative disease. However, it remains controversial as whether posterior internal fixation is required when LLIF is performed. This meta-analysis aims to compare the radiographic and clinical results between instrumented and stand-alone LLIF. Methods PubMed, EMBASE and Cochrane Collaboration Library up to March 2023 were searched for studies that compared instrumented and stand-alone LLIF in the treatment of lumbar degenerative disease. The following outcomes were extracted for comparison: interbody fusion rate, cage subsidence rate, reoperation rate, restoration of disc height, segmental lordosis, lumbar lordosis, visual analog scale (VAS) scores of low-back and leg pain and Oswestry Disability Index (ODI) scores. Results 13 studies involving 1063 patients were included. The pooled results showed that instrumented LLIF had higher fusion rate (OR 2.09; 95% CI 1.16–3.75; P = 0.01), lower cage subsidence (OR 0.50; 95% CI 0.37–0.68; P < 0.001) and reoperation rate (OR 0.28; 95% CI 0.10–0.79; P = 0.02), and more restoration of disc height (MD 0.85; 95% CI 0.18–1.53; P = 0.01) than stand-alone LLIF. The ODI and VAS scores were similar between instrumented and stand-alone LLIF at the last follow-up. Conclusions Based on this meta-analysis, instrumented LLIF is associated with higher rate of fusion, lower rate of cage subsidence and reoperation, and more restoration of disc height than stand-alone LLIF. For patients with high risk factors of cage subsidence, instrumented LLIF should be applied to reduce postoperative complications. |
| first_indexed | 2024-03-07T15:25:06Z |
| format | Article |
| id | doaj.art-b2d94fbdc77144b18e02b14b6466f4a7 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-07T15:25:06Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-b2d94fbdc77144b18e02b14b6466f4a72024-03-05T17:24:28ZengBMCBMC Musculoskeletal Disorders1471-24742024-02-012511910.1186/s12891-024-07214-6Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysisLianghai Jiang0Lantao Liu1Liang Dong2Zhengwei Xu3Xiaobo Zhang4Lixiong Qian5Department of Spine Surgery, Qingdao Municipal HospitalDepartment of Spine Surgery, Qingdao Municipal HospitalDepartment of Orthopedic, Honghui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopedic, Honghui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopedic, Honghui Hospital, Xi’an Jiaotong University College of MedicineDepartment of Orthopedic, Honghui Hospital, Xi’an Jiaotong University College of MedicineAbstract Background Both instrumented and stand-alone lateral lumbar interbody fusion (LLIF) have been widely used to treat lumbar degenerative disease. However, it remains controversial as whether posterior internal fixation is required when LLIF is performed. This meta-analysis aims to compare the radiographic and clinical results between instrumented and stand-alone LLIF. Methods PubMed, EMBASE and Cochrane Collaboration Library up to March 2023 were searched for studies that compared instrumented and stand-alone LLIF in the treatment of lumbar degenerative disease. The following outcomes were extracted for comparison: interbody fusion rate, cage subsidence rate, reoperation rate, restoration of disc height, segmental lordosis, lumbar lordosis, visual analog scale (VAS) scores of low-back and leg pain and Oswestry Disability Index (ODI) scores. Results 13 studies involving 1063 patients were included. The pooled results showed that instrumented LLIF had higher fusion rate (OR 2.09; 95% CI 1.16–3.75; P = 0.01), lower cage subsidence (OR 0.50; 95% CI 0.37–0.68; P < 0.001) and reoperation rate (OR 0.28; 95% CI 0.10–0.79; P = 0.02), and more restoration of disc height (MD 0.85; 95% CI 0.18–1.53; P = 0.01) than stand-alone LLIF. The ODI and VAS scores were similar between instrumented and stand-alone LLIF at the last follow-up. Conclusions Based on this meta-analysis, instrumented LLIF is associated with higher rate of fusion, lower rate of cage subsidence and reoperation, and more restoration of disc height than stand-alone LLIF. For patients with high risk factors of cage subsidence, instrumented LLIF should be applied to reduce postoperative complications.https://doi.org/10.1186/s12891-024-07214-6Degenerative diseaseFusionLumbarStand-alone |
| spellingShingle | Lianghai Jiang Lantao Liu Liang Dong Zhengwei Xu Xiaobo Zhang Lixiong Qian Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis BMC Musculoskeletal Disorders Degenerative disease Fusion Lumbar Stand-alone |
| title | Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis |
| title_full | Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis |
| title_fullStr | Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis |
| title_full_unstemmed | Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis |
| title_short | Comparison of instrumented and stand-alone lateral lumbar interbody fusion for lumbar degenerative disease: a systematic review and meta-analysis |
| title_sort | comparison of instrumented and stand alone lateral lumbar interbody fusion for lumbar degenerative disease a systematic review and meta analysis |
| topic | Degenerative disease Fusion Lumbar Stand-alone |
| url | https://doi.org/10.1186/s12891-024-07214-6 |
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